Alcoholic liver disease

Also known as: Liver disease due to alcohol, Cirrhosis or hepatitis - alcoholic or Laennec's cirrhosis

Definition

Alcoholic liver disease is damage to the liver and its function due to alcohol abuse.

Causes

Alcoholic liver disease occurs after years of heavy drinking. Over time, scarring and cirrhosis can occur. Cirrhosis is the final phase of alcoholic liver disease.

Alcoholic liver disease does not occur in all heavy drinkers. The chances of getting liver disease go up the longer you have been drinking and more alcohol you consume. You do not have to get drunk for the disease to happen.

The disease seems to be more common in some families. Women may be more likely to have this problem than men.

Symptoms

There may be no symptoms, or symptoms may come on slowly, depending on how well the liver is working. Symptoms tend to be worse after a period of heavy drinking.

Early symptoms include:

Fatigue and loss of energy

Poor appetite and weight loss

Nausea or belly pain

Small, red spider-like blood vessels on the skin

As liver function worsens, symptoms may include:

Fluid buildup of the legs (edema) and in the abdomen (ascites)

Yellow color in the skin, mucous membranes, or eyes (jaundice)

Redness on the palms of the hands

In men, impotence, shrinking of the testicles, and breast swelling

Easy bruising and abnormal bleeding

Confusion or problems thinking

Pale or clay-colored stools

Exams and Tests

Your health care provider will do a physical exam to look for:

An enlarged liver or spleen

Excess breast tissue

Swollen abdomen, as a result of too much fluid

Reddened palms

Red spider-like blood vessels on the skin

Small testicles

Widened veins in the abdomen wall

Yellow eyes or skin (jaundice)

Tests you may have include:

Complete blood count (CBC)

Liver biopsy

Liver function tests

Coagulation studies

Tests to rule out other diseases include:

Abdominal CT scan

Blood tests for other causes of liver disease

Ultrasound of the abdomen

Treatment

LIFESTYLE CHANGES

Some things you can do to help take care of your liver disease are:

Drink less alcohol.

Eat a healthy diet that is low in salt.

Get vaccinated for diseases such as influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia.

Talk to your doctor about all medicines you take, including herbs and supplements and over-the-counter medicines.

MEDICINES FROM YOUR DOCTOR

"Water pills" (diuretics) to get rid of fluid build-up

Vitamin K or blood products to prevent excess bleeding

Medicines for mental confusion

Antibiotics for infections

OTHER TREATMENTS

Endoscopic treatments for enlarged veins in the throat (bleeding varices)

Removal of fluid from the abdomen (paracentesis)

Placement of a transjugular intrahepatic portosystemic shunt (TIPS) to repair blood flow in the liver

When cirrhosis progresses to end-stage liver disease, a liver transplant may be needed.

Support Groups

Outlook (Prognosis)

Continued excessive drinking can shorten your lifespan. Your risk for complications such as bleeding, brain changes, and severe liver damage go up. The outcome will likely be poor if you keep drinking.

Cirrhosis is caused by scarring of the liver. In most cases, the liver cannot heal or return to normal function once the damage is severe. Cirrhosis can lead to serious complications.

Possible Complications

Complications may include:

Bleeding disorders (coagulopathy)

Buildup of fluid in the abdomen (ascites) and infection of the fluid (bacterial peritonitis)

Enlarged veins in the esophagus, stomach, or intestines that bleed easily (esophageal varices)

Increased pressure in the blood vessels of the liver (portal hypertension)

Kidney failure (hepatorenal syndrome)

Liver cancer (hepatocellular carcinoma)

Mental confusion, change in the level of consciousness, or coma (hepatic encephalopathy)

When to Contact a Medical Professional

Call your provider if:

You develop symptoms of alcoholic liver disease.

You develop symptoms after a long period of heavy drinking.

You are worried that drinking may be harming your health.

Get emergency medical help right away if you have:

Abdominal or chest pain

Abdominal swelling or ascites that is new or suddenly becomes worse

A fever (temperature greater than 101°F, or 38.3°C)

Diarrhea

New confusion or a change in alertness, or it gets worse

Rectal bleeding, vomiting blood, or blood in the urine

Shortness of breath

Vomiting more than once a day

Yellowing skin or eyes (jaundice) that is new or gets worse quickly

Prevention

Talk to your provider about your alcohol intake. The provider can counsel you about how much alcohol is safe for you.

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